At Specialized Nursing Services (SNS), advocacy is a term that has great significance and multiple meanings. The dedicated administrators and multidisciplinary staff of this fully accredited Medicare home healthcare agency that has been serving Broward and Dade Counties for 21 years believe that their primary role is to serve as advocates for their clients, who often have medically complex conditions and cannot speak for themselves. They provide a voice, a safety net and a competent, humane partner who can make sure that the needs of their clients – medical, emotional, safety, social and daily living needs – are being met as effectively as possible. At SNS, advocacy for patients is part of the agency’s DNA; it means assuring that they receive the services, supports and resources they need to experience the highest possible quality of life in their chosen place of residence, despite illness, disability or frailty. Advocacy means steadfast support for the client and for the client’s family.

 

Advocacy also means support for home care as part of the healthcare system. While advocacy for the client is an integral aspect of the SNS philosophy, at SNS it actually goes beyond the client and encompasses the specialty of home healthcare as a whole. SNS advocates for home healthcare as a critical element within healthcare, one that transitions patients from hospital to home and keeps patients at home. “Home healthcare providers such as SNS are the bridge between the hospital and a recovering and satisfied patient,” explains Iovanna Lopez, MA, MS, administrator and co-owner of SNS. “Home care is an alternative to nursing homes; it has been proven to greatly reduce healthcare costs by keeping patients out of the expensive settings of the hospital and nursing home.”

 

But proposed Medicare cuts to home healthcare, as part of healthcare reform legislation, threaten the health of the home care industry. Ironically, this is happening even as the need for home care is growing.

 

Home healthcare has countless benefits. It complements the care provided by family members, giving them support, respite and a knowledgeable partner. It serves as a link between patient and physician, monitoring the patient’s status and informing the physician of early signs of complications such as infection. Home healthcare staff members teach patients and family members, monitor the safety of the home environment and assure that treatment regimens are followed and medications are taken. Above all, home healthcare services make it possible for the elderly, disabled and chronically ill to live with safety and dignity in the comfort and familiarity of their own homes – a preference that is nearly universal.

 

For the healthcare industry, SNS represents an essential element of the care continuum. Home care makes shorter hospital admissions possible and reduces the likelihood of costly re-admissions; home care keeps patients out of nursing homes.

 

In the future, home healthcare services will be increasingly important – even critically important. The demand for such services is expected to increase as the nation’s 78 million Baby Boomers reach their senior years. As healthcare reform is implemented across the U.S., home health organizations will play a potentially major role. “Healthcare reform is seeking to prevent re-admissions,” Lopez explains. “Reform legislation calls for financial penalties to hospitals when re-admissions occur within 30 days of discharge, for certain diagnoses. Home healthcare organizations are a solution to this: we can help hospitals prevent and reduce these costly re-admissions by implementing clinical pathways to wellness following hospital discharge

 

“There is a new burden on hospitals to make sure that a discharged patient is not re-admitted. Home care services help hospitals achieve this. Our services help patients recover and through teaching self-management of chronic illnesses, we empower patients and families to take control of their health. Healthcare reform should encourage home care as a solution and a means of reducing costs.”

 

Despite this, healthcare reform legislation proposes $39.7 billion in Medicare cuts for home healthcare, plus co-payments for home care patients. As Lopez points out, home care already saves Medicare substantial amounts. “There is a need for healthcare reform, and we need to have controls in place to prevent Medicare abuses. We recognize the need to be accountable and measurable. But reform that entails cuts in Medicare reimbursement to home healthcare providers is not going to reduce the deficit or keep patients out of hospitals. Admissions are not only costly; they create distress for the patient and family.”

 

State Senator Rene Garcia, who represents Miami Dade County, has long been a passionate advocate for access to quality health care. SNS has been meeting with Senator Garcia to educate him about the problem through firsthand encounters with patients and families who will be adversely affected by health reform’s impact on home healthcare. “As home healthcare providers, we’re partners with doctors and hospitals,” says Lopez. “We all have the same goal: that our patients are as healthy as possible, with the highest possible quality of life. We are all trying to reduce readmissions; we all need each other, working together.”